Health Committee on May 9th, 2007

Evidence of meeting #54 for Health in the 39th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cdr.

A recording is available from Parliament.

On the agenda

Prescription Drugs

Committee Business

MPs speaking

Also speaking

Janis Miyasaki Associate Clinical Director and Chair of the Technology and Therapeutics Assessment Subcommittee, American Academy of Neurology, University of Toronto

Joel Lexchin Professor, School of Health Policy and Management, York University

David Bougher Former Member of the Federal, Provincial and Territorial Pharmaceutical Issues Committee, As an Individual

Linda Tennant Former Member of the Federal, Provincial and Territorial Pharmaceutical Issues Committee, As an Individual

Louise Binder Chair, Best Medicines Coalition

Elisabeth Fowler Vice-President, Health Policy, Ward Health Strategies

Linda Wilhelm

4:40 p.m.

Professor, School of Health Policy and Management, York University

Dr. Joel Lexchin

We used a set of criteria to decide which agencies to compare to.

First of all, they had to use the same kind of evidence that the CDR uses, which is a combination of pharmaco-economic analysis and clinical evidence. They had to have evaluated at least half of the CDR drugs. They had to publish their material on the web. They had to make more decisions than just yes or no, so they had to have at least a third category of decision--in other words, fund with restrictions. All of those things were the bases on which we chose the comparisons.

Quebec didn't fit that, so we didn't use Quebec. That doesn't mean Quebec decisions are right or wrong; it just means that Quebec didn't turn up in the bases on which we chose the countries.

Why does Quebec fund more drugs than other provinces? There are a variety of reasons. It could be that the social priorities of Quebec are such that you are willing to put more money into drugs than other provinces are. It could be that Quebec feels that by listing more drugs, they will get more economic activity out of the drug companies, since a large number of them are located in the Montreal area, and sometimes drug companies make implicit promises that if drugs are funded, they will increase investment. There are a variety of reasons Quebec may choose to put more drugs on its formulary than other places, but we didn't explore that.

4:40 p.m.

Bloc

Christiane Gagnon Bloc Québec, QC

Did you do any comparative studies with the rest of Canada on the quality of life or the health of patients who are taking the medications? Have you evaluated the effectiveness of these medications? This is what we are being asked.

Some witnesses have come to tell us that access to new medications was difficult, because many were rejected, especially medications for rare diseases. Some would even like to see different processes for different diseases, because the sample is too small and too many products are rejected. In Quebec, the process is different. Does that have a more positive impact on the patients' quality of life?

4:40 p.m.

Professor, School of Health Policy and Management, York University

Dr. Joel Lexchin

I think it would be a good idea to compare quality of life in a different group of patients with the same disease in different provinces, where access to care is different, but those kinds of studies haven't been done. If CIHR wants to fund those, I'd be happy to put in an application for money, but nobody has looked at that. It's a valid point, and something worth pursuing.

4:40 p.m.

Conservative

The Chair Conservative Rob Merrifield

Thank you very much.

Mr. Fletcher, you have five minutes.

May 9th, 2007 / 4:40 p.m.

Conservative

Steven Fletcher Conservative Charleswood—St. James—Assiniboia, MB

Thank you, Mr. Chair.

Mr. Chair, I notice that the idea of an independent review has come up again at this meeting. Perhaps that is something this committee should consider when we come out with our final report.

As in every other committee, in this committee there doesn't seem to be enough time to ask all the questions I would like, so I'll focus on the Best Medicines Coalition. I'm just reading about your group. You say you're a national group of organizations representing millions of Canadians. What types of organizations make up your coalition? Please give a quick answer.

4:40 p.m.

Chair, Best Medicines Coalition

Louise Binder

They're all disease and disability groups. I won't remember them all, but Linda is representing the arthritis community here. There's hepatitis C and HIV. The cancer advocacy group and the breast cancer group are represented. I actually have a list. It's a broad-based group. There's a diabetes representative and others for a number of different diseases and disabilities.